Staff Shortages
Shortages of staff are widespread within the NHS and exist across all disciplines. The NHS has too few nurses, midwives, GPs, hospital doctors and mental health workers. Staff are leaving the service due to low pay, work-related stress and reduced job satisfaction, whilst recruitment and retention continues to be a growing problem.
Recent developments
The Labour government came into power in 2024, but to date there have been few moves that will result in an improvement in NHS staffing.
In early April 2025, changes to visa rules announced by the Home Office increased the minimum salary threshold for a Skilled Worker visa from £23,200 to £25,000, which is below the current entry-level salary for a band 3 NHS worker, including nursing support workers.
The Royal College of Nursing wrote to the home secretary Yvette Cooper warning that unless the next pay award brings band 3s back above this threshold, it risks making entry-level NHS band 3 workers permanently ineligible. This could have significant ramifications for the nursing workforce.
Agency and bank staff cost NHS millions
The NHS has a major staffing crisis, something that has been obvious to everyone working in the NHS for many years. Well over a decade of underinvestment in training new staff and lack of measures to retain existing staff has led to increased pressure on existing staff. As the work pressures increase and pay and conditions remain poor, staff leave, which then increases the pressure on remaining staff still further.
In July 2022, the health and select committee within Parliament heard that almost every healthcare profession was facing shortages, with at least 105,000 vacancies.
Staff shortages affect the safety and quality of care and details are discussed below for separate areas, but lack of staff also leads to increased costs due to spend on agency staff.
In April 2025, the HSJ saw internal NHS England figures which revealed that providers were on course to spend £8.3bn on temporary staffing in 2024/25. Although this is down from just under £10bn in 2023/24, it remains much higher than the £5.8bn spent in 2018/19 by NHS trusts on temporary staff.
Three quarters of the overall spend in 2024/25 (£6bn) went on employing bank workers, with the remainder used for agency staff.
The figure has been rising since the pandemic, up to over £6.2bn in 2019/20 and in 2021/22, the NHS paid out £9.2bn on additional staff, of which £3bn was on agency staff, up 20% on the previous year.
A workforce plan
In June 2023, the Conservative government finally published a long-term workforce plan. Although initially welcomed by the Royal Colleges and NHS organisations, it soon became clear that there were problems with the plan and many are sceptical about whether it would lead to sufficient increase in staff numbers. More details of the plan can be found here and criticisms of the plan can be found here.
Although the Conservatives are no longer in government, the issue of filling vacancies and having sufficient staff for the predicted increase in demand over the next couple of decades is the same.
The projections in the workforce plan are for the number of people over the age of 85 to grow by 55% by 2037, and this risks a shortfall of NHS staff of between 260,000 and 360,000 by 2036-37.
The Conservatives thought their plan would produce 300,000 extra doctors, nurses and other health professionals by 2037. The key to achieving this is, according to the plan, was a combination of training, retention and reform.
Criticisms of the plan include the planned reduction in length of medical degree courses (5-6 years to 4 years) and the general vagueness around who will train the expansion in medical students. There was also uncertainty over funding, particularly after the first 5 years of the 14 year plan.
The most striking thing about the plan was the total absence of any mention of pay and its importance in retention. At the time the plan was published, the NHS was experiencing a wave of strikes over pay involving a broad spectrum of clinical staff, yet the plan makes no mention of pay whatsoever.
Pay is “the elephant in the room” according to the Hospital Consultants and Specialists Association, and the BMA noted that:
“Training new doctors will be to no avail if they don’t stay in the workforce, so the focus on retention is important – but doctors need to be valued fairly for their work and expertise or they will leave for better-paid jobs elsewhere. This plan is set up to fail if doctors’ pay continues to be eroded, the pay review process continues to be interfered with and pay disparities across the public health system persist.”
In October 2023, the cross-party Public Accounts Committee heavily criticised the workforce plan in a report, in particular the lack of funding estimates and it has “serious doubts” on how the plan would be achieved.
The committee noted that the “unfunded and uncosted” workforce plan, which promised to train thousands more GPs and double medical school places, risked placing the NHS under ‘unsustainable financial pressure’ in the future.
Dame Meg Hillier MP, chair of the committee, said: “The government and health system need to be alert to the serious doubts our report lays out around the workforce crisis, both the approach to tackling it now and the additional costs funding it in the future.”
The workforce situation built up over the years of Conservative government, despite increasing pressure from many groups. In November 2022, a coalition of over 100 health and care organisations, including the Royal College of Physicians (RCP), signed a letter to the Chancellor in support of publishing the NHS long-term workforce plan in full, including assessments of how many staff will be needed to keep pace with demand.
As well as not producing a workforce plan, they voted against an amendment to the recent Health & Social Care Bill that would have required the government to publish independently verified forecasts of the workforce numbers needed across the NHS to ensure that services are safely staffed.
To protect the patients the NHS must have the right number and mix of staff, with the right level of education, qualification and experience. Numerous studies show that low nurse staffing levels were associated with higher rates of falls and deaths and major safety issues in midwifery. These include The Keogh review, the Berwick review, and the Ockenden review of midwifery.
The parliamentary committee’s report noted:
“The persistent understaffing of the NHS now poses a serious risk to staff and patient safety both for routine and emergency care. It also costs more as patients present later with more serious illness.”
Latest vacancy data
The latest NHS Digital vacancy statistics show 106,432 vacancies across England at 31 December 2024. For the Registered Nursing staff group (which includes midwives and health visitors) alone there was a vacancy rate of 6.4% or 27,452 vacancies.
Why is there a shortage of staff?
There are a number of factors behind this shortage of staff:
- lack of long-term planning by the government, which means not enough staff have been trained over the past decade or more;
- removal of the nursing and other bursaries (now partially reversed);
- low pay;
- brexit leading to a loss of staff from the EU and a reduction in staff coming from EU countries;
- job pressure and high workload made worse due to a lack of staff meaning working conditions for many are untenable and staff leave.
Things were difficult prior to the pandemic, but the Covid pandemic then the cost of living crisis escalated the pressure on staff and consequently the difficulty of retaining staff.
In March 2025, the RCN published the results of its staff survey, which revealed that nursing staff working in England's NHS "face a tide of racism, abuse and bullying while an overstretched, under-resourced, underpaid workforce is causing many to work hours without pay and others to work while unwell."
The RCN said this NHS Staff Survey findings provide "an urgent reality check for government ministers and lay bare the impact of workforce shortages."
The survey shows a shocking 35% have experienced bullying, harassment or abuse at work from patients, their relatives or other members of the public.
Additionally, 14% of nursing and midwifery staff have faced discrimination at work from patients, their relatives or other members of the public in the last 12 months, with 66% citing discrimination on the grounds of their ethnic background.
Staff shortages continue to be a huge concern. Only 31% say there are enough staff to enable them to do their job properly, and 45% say they felt unwell due to work-related stress. More than half (58%) came to work despite feeling not well enough to perform their duties, which is a 9% point increase from 2020.
Pay continues to be a significant issue for those on the frontline of care, with just 27% saying they are satisfied with their level of pay. In a worrying sign of workforce shortages, more than half (58%) said they worked unpaid overtime every week and nearly a third (29%) said they often think about leaving their current organisation.
Recent years has seen NHS trusts giving their staff hardship grants, low-cost meals and money to buy their children’s school uniforms to help them cope with the deepening cost of living crisis. Others have set up food banks, are subsidising public transport fares and advising hard-up frontline personnel how to access supermarket vouchers to help feed their families.
When nothing is done about staff shortages there is a spiral of events that leads to ever greater pressure on staff.
Too few nurses
Issues with both recruitment and retention
There is a major issue with nurse recruitment and retention. The overall number of nurses employed has increased, but this doesn't meet the increased demand. In December 2024, for the Registered Nursing staff group (which includes midwives and health visitors) alone there was a vacancy rate of 6.4% or 27,452 vacancies
Although this increased demand for nurses was widely predicted, government policy over the past decade has hampered the NHS's ability to cope with it.
The accumulative effect of years of Conservative government policies has led to a significant shortfall in the number of nursing staff.
Student numbers continue to fall
In February 2025, the number of people applying to study nursing was reported to be at a record low. There was a 35% fall in the number of people applying to study nursing in England, with only 23,730 applications in 2025, compared with 36,410 in 2021.
The RCN noted that the UK government must launch an urgent, fully funded student recruitment campaign to address the crisis before September’s student intake. The RCN says the UK government must make nursing a more attractive degree and career by introducing a loan-forgiveness model for students who commit to working in the NHS and wider public services, alongside universal, uplifted maintenance grants.
Removal of nursing bursary
In 2015, the nursing bursary was removed by the Conservative government, which led to a drop in applications to nursing. The Royal College of Nursing (RCN) said the policy has been very damaging and was a key reason why the number of unfilled vacancies in nursing in the NHS in England rose to 43,000 by 2019.
In 2019 the Conservative government under pressure partially reversed the policy and reinstated a maintenance grant, plus those who plan to work in areas with severe shortages of nurses, or in one of the areas of care where the lack of nurses is acute – such as mental health or learning disability care – will receive another £3,000. However, students still have to pay the £9,000 per year tuition fees, and although the RCN welcomed the grants, it wanted a return of full packages of financial support for training nurses, including paying tuition fees for student nurses.
The impact of Brexit
The Brexit vote in 2016 led to a substantial drop in nurses and midwifes coming to the UK from EU countries, down 87% from 6,400 in 2016/17 to 800 in 2017/18.
The impact of the pandemic
The Covid pandemic significantly increased the strain on frontline nurses. The RCN was concerned that the extra responsibility and pressure placed on nurses could increase the rate of staff “burnout”. This comes amid successive waves of Covid patients, the annual pressures that accompany the winter and the inevitable struggle to clear the growing backlog of cancelled appointments from 2020.
High international recruitment enables target to be met
In its 2019 manifesto the Conservative government set a target of recruiting 50,000 additional FTE registered nurses in the NHS HCHS and general practice in England by the end of the current parliament.
In December 2023, NHS England’s chief nursing officer revealed that 93% of the 51,245 nurses who had joined the NHS in the last four years have been recruited from overseas.
The original intention was that international recruitment would make up just a quarter of the 50,000 target, with the remainder of the total coming from domestic recruitment and retention
In November 2023, a new analysis from the Royal College of Nursing (RCN) showed the “inadequacy” of the government’s political target to recruit 50,000 nurses.
The report highlighted that official statistics show there has been a 16% increase in nursing staff, but patient waiting lists have grown 70% since the target was set.
There is also a number of problems with international recruitment and the RCN has warned that large-scale international recruitment is “expensive, unsustainable, and unethical” given global nursing workforce shortages.
See also The Lowdown article on international recruitment and why it's not the answer to the nurse shortage.
Two few midwives
Financial pressures mean number of UK-trained midwives continues to fall
In December 2024, new data from the Nursing and Midwifery Council (NMC) showed a 12.5% fall in the number of UK-educated midwives joining the NMC register.
The RCM noted that in its State of UK Midwifery Student Finance report published in September 2024, it highlighted the impact of tuition fees and living expenses that are forcing student midwives out of a career in midwifery. The report noted that an increasing number of students are leaving their courses before completion because they simply can’t afford to continue. This, the RCM says, has undoubtedly impacted on the current staffing levels and the recruitment and retention crisis engulfing maternity services.
The State of UK Midwifery Student Finance report highlighted that three-quarters of midwifery students in England are graduating with debts exceeding £40,000. Student midwives in England were dealt a further blow when earlier this month an increase of 3.1% to their fees was announced.
The NMC noted:
“The Government cannot say we did not warn them of this unfolding crisis. From the moment the bursary was taken away from students, we’ve known that a career in midwifery would be out of reach for many. Midwives are likely to spend their careers entirely in the NHS, yet they start with nearly £40,000 of debt. That’s why we’ve called on the Government to forgive that debt after working at least three years as an NHS midwife. We already have a shortage of midwives. Unless we stem this decline in new UK-educated registrants, that shortage – and the quality of care that is available to women and families – will only worsen.”
The RCM has offered the new Government solutions to the staff retention crisis in its How to Fix the Midwifery Staffing Crisis.
Staffing shortages make career less attractive
In July 2024, the Nursing and Midwifery Council’s (NMC’s) annual data report revealed that compared to nurses’ midwives are less likely to recommend their career choice.
Midwives had concerns over staffing shortages and the impact they have on the delivery of good quality care were some of the top reasons why midwives have left the profession and why they did not recommend their career. With almost a quarter (22%) of midwives being more likely than nurses to cite poor staffing as a factor in their decision to leave the profession.
One midwife* told the NMC that the staffing crisis made her anxious before going into work. Not knowing how many midwives would be on the shift, and if she would have been juggled with agency staff was a worry.
Warnings on midwife numbers issues time and time again
The lack of midwives has been known for several years. The July 2022 parliamentary committee report notes a serious shortage of midwives and the pressures on maternity services.
A year previous in July 2021, the committee said that NHSE needed an additional 2,000 midwives and 500 obstetricians to operate at a level that the staffing tool Birthrate Plus considered safe. This recommendation was supported by the Ockenden report and accepted by the Government. However, despite this, the NHS in England lost 552 midwives between March 2021 and March 2022.
Ockenden report highlighted staff shortages
The final Ockenden report into the failings in maternity care at Shrewsbury and Telford NHS Trust published in March 2022 identified midwifery staffing shortages across the service, resulting in unmanageable workloads, a lack of support for junior midwives and doctors, and delays in the appropriate review and management of care for women and babies.
The report called on the Government to ensure there is sufficient funding to deliver safe staffing levels, to enable staff to deliver safe care. This is something the RCM has been telling successive Health Secretaries for over a decade.
In April 2022, the Royal College of Midwives (RCM) noted that due to over a decade of underfunding some NHS trusts and boards have to base midwifery staffing levels on what they can afford, not women and baby’s needs.
An ever decreasing number of GPs
GP numbers - promises not met and numbers fall
There are widespread problems with both the training and recruitment of new GPs and the retention of current GPs. In 2015 the Conservative Government promised 5,000 extra GPs by 2020, then extended to 2021. In 2016 and 2017, the pledge was repeated. In the 2019 general election campaign, Boris Johnson announced a new commitment to increase the number of GPs in England by 6,000 by 2024. However, Sajid Javid, the then health secretary, admitted in November 2021 that this pledge was unlikely to be met because so many family doctors were retiring early. And indeed, the pledge was never met and the overall number of GPs (including GP trainees) has seen little growth since 2015, while the number of GP partners has declined significantly during this time.
As of March 2025, there were 38,800 individual (headcount) fully qualified GPs working in the NHS in England. In Full Time Equivalent (FTE) terms of 37.5 hours a week, this equates to 28,281 full-time fully qualified GPs.
There were the equivalent of 1,083 fewer fully qualified full-time GPs in March 2025 than there were in September 2015 (when the current data collection method began). In recent months the numbers of fully qualified GPs has started to increase, up 707 fully qualified FTE GPs in the last 12 months.
The GP partner workforce has been shrinking since 2015 when this dataset began, with the loss of 6,056 FTE GP partners during this time. In March 2025 there were 15,599 FTE GP partners compared to 16,143 in March 2024: a total loss of 544 FTE GP partners in the last year alone. On a headcount basis, there was a loss of 580 GP partners in the last year.
A high rate of GPs taking retirement is often cited as the reason behind the falling numbers, but organisations representing GPs, such as the BMA, also say heavy workloads, rising expectations among patients, excess bureaucracy, a lack of other health professionals working alongside them in surgeries, and concern that overwork may lead to them making mistakes are also leading to GPs quitting in order to improve their mental health and work-life balance.
Source: The Nuffield Trust (December 2024)
High number of practice closures
Over recent years, the GP sector has seen high numbers of practice closures. Pulse began investigating the issue in 2013, when just 18 practices shut their doors. A Pulse investigation published in August 2022 shows that 474 GP surgeries across England have closed in the past nine years without being replaced, with small practices on lower funding in more deprived areas most likely to be affected. This leaves 1.5 m patients having to find a new GP, many of them will have to travel a number of miles to a new surgery.
The BMA reported that as of March 2025, 1,404 practices have closed since 2015. Factors causing this can include partner retirements, the inability to recruit staff or GP partners.
Whilst the GP workforce has been declining, the number of patients continues to increase, demonstrating the ever-mounting workload in general practice. In March 2025 a record-high of 63.77 million patients were registered with GP practices in England, an increase of 6.86 million since 2015. As a result, the average number of patients each full-time equivalent GP is responsible for now stands at 2,255. This is an increase of 317 patients per GP (16.4%) since 2015.
Regional inequality in GP numbers
In addition to staffing concerns nationally within general practice, there are serious inequalities regionally. Analysis by the Institute of Government found a substantial variation in the number of GPs per weighted patient when grouping practices by the deprivation of their patient lists. There were 38.0 fully qualified permanent GPs per 100,000 weighted patients in the practices with the most deprived decile of patients in March 2024. In comparison, the least deprived decile had 49.0 GPs (28.8% higher), though when including GP trainees the gap is slightly smaller (21.8%).
Too few hospital doctors
Low numbers compared to other countries
Data collated by the BMA shows that the average number of doctors per 1,000 people across the EU members of the OECD, for which data is available, is currently 3.9. Germany has 4.5. England, by comparison, has just 3.2 and would need an additional 40,000 doctors to reach the OECD EU average.
There is also significant regional variation in the distribution of doctors, with some areas falling even further below the OECD EU average. The East of England, for example, has just 2.5 doctors per 1000 people.
Doctor numbers are increasing
2022 research by the Nuffield Trust submitted to the Health and Social Care Parliamentary committee suggests that the NHS in England was short of 12,000 hospital doctors.
Overall, the number of doctors working in the NHS is steadily increasing. In January 2024 (latest data), NHS secondary care had 42,720 more FTE doctors than September 2015, up 41%. The rate of change has increased in recent years, reaching an annual growth rate of over 5% in 2024.
Problems with retention
In July 2024, The Royal College of Physicians, Royal College of Physicians of Edinburgh and Royal College of Physicians and Surgeons of Glasgow reported the findings of the latest UK consultant physician workforce census. It revealed "overwhelming workloads, poor IT equipment that saps doctors’ time, widespread staff vacancies and plummeting job satisfaction." The Colleges reported that unless things improved the NHS was in danger of losing critical senior staff and must be a key priority for the Labour government.
The census found that nearly two in five (39%) UK consultant physicians say they have an excessive workload almost all or most of the time, while almost one in a five (18%) ‘almost never’ feel in control of their workload.
Almost half of UK consultant physicians surveyed (47%) reported that enjoyment in their job had decreased over the last year – with clinical workload, poorly functioning IT equipment and staff vacancies cited as the top three reasons, followed by a lack of administrative support and lack of capacity in social care to discharge patients in a timely manner.
The census also revealed widespread vacancies with 59% of UK consultant physicians reporting at least one consultant vacancy in their department, while 62% reported daily or weekly trainee rota gaps. 69% said gaps in consultant physician rotas were having a negative impact on patient care.
Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh said:
“The census highlights that the UK continues to operate with too few doctors. This puts a strain on our medical workforce, through increased workloads and rota gaps, leading to stress and burnout in many instances. 69% of consultants feel stressed at work, for example."
BMA says pay is an issue
According to the latest BMA pay review, declines in doctors pay has had a damaging impact on the morale of frontline NHS staff. This has contributed to a workforce crisis in the NHS and has had a detrimental effect on its ability to recruit and retain doctors.
A study by the Institute of Economic Affairs suggests that importing doctors from abroad will be “essential” over the next decade. However, this could be complicated due to Brexit and the predicted increase in competition internationally for doctors.
Mental health services lack staff
Shortages causing a crisis in services
Mental health services are experiencing staff shortages across the board - nurses, therapists and psychiatrists. Despite many commitments to bolster the workforce, any increase has not been sufficient. The result is very long waiting times and increased visits to A&E for patients in crisis, with a major knock-on effects on services for those with physical illnesses.
Patients already on wards are not having one-to-one therapy sessions, not receiving medication on time, and activities are being cancelled due to insufficient staffing. Staffing issues also impact on community services, where a lack of qualified staff leads to long waits and difficulties providing safe care.
Prior to the Covid pandemic, demand rose year on year, but in early 2021 The Royal College of Psychiatrists warned that England is now “in the grip of a mental health crisis” as a result of the Covid pandemic.
Between 2009 and 2020 there was a 12% drop in the number of mental health nursing posts. Both psychiatry clinicians and psychologists are listed on the Migration Advisory Committee’s list of occupations experiencing staff shortages.
In recent years, staffing levels have improved but failed to keep up with the rise in prevalence of mental health disorders. A survey released by NHS England in November 2023, found one in five children and young people in England aged eight to 25 have a probable mental disorder, with large rises in the last few years in the number with eating disorders.
But data from NHS England shows that these children and young people are struggling to get access to care, with over 24,000 waiting almost two years to receive any help.
The analysis also shows 19,000 adults with a serious mental illness waiting for longer than 18 months for a second contact with community mental health services. In total, almost 240,000 children and young people were waiting for treatment from community mental health services in August 2023, as well as more than 192,000 adults.
An analysis of the NHS situation by the King’s Fund published in February 2024, found that the current numbers of mental health beds (17,836) are at their lowest level since data collection began in 2010/11. Bed occupancy was consistently over the recommended level of 85% , which is the point at which quality of care is at risk of being compromised.
The knock-on effect of dwindling bed numbers and staff is that A&E visits have increased, with waits of up to 80 hours for some mental health patients. Patients are not found suitable care, instead they are admitted into inappropriate acute hospital beds meant for physically ill patients.
The latest mental health services dataset released by NHS Digital in July 2024 showed that active out-of-area placements were at 805, the second highest level in five years, despite many promises over the years to phase such placements out, as they are known to be detrimental to a patient’s ability to recover.
Analysis from the Royal College of Psychiatrists (RCPsych) in November 2024, found that the number of children and young people accessing treatment for mental health conditions in England has risen by 27% (from 628,454 to 798,479) in just three years from September 2021 to September 2024.
Over the same period, Child and Adolescent mental health services (CAMHS) have struggled to recruit enough consultant psychiatrists across England. The latest RCPsych Workforce census found that CAMHS has faced the highest consultant vacancy rate of any psychiatric specialism.
The census found that of 842 available child and adolescent consultant psychiatrist posts in England, one in five (19.2% or 162 posts) were vacant. Combined with posts being covered by locums, the total vacancy rate is now more than one in three (36.8% or 310 posts).
An analysis of NHS England data by the Royal College of Psychiatrists found 319 children and adolescents in England were forced to travel out of their area for mental health treatment from December 2023 to November 2024. This represents nearly one child every day.
In January 2025, an investigation by the RCP found that nearly one in five senior mental health roles in Scotland are either vacant or filled by locums. Across the whole of Scotland, 101 consultant psychiatrist posts out of 536 whole-time equivalent roles are currently vacant.
Posts going unfilled
The Royal College of Psychiatrists’ 2023 census found that there were 6,096 consultant posts in organisations across the UK, 84.2% (5,133) of which were filled with substantive and locum consultants. The proportion of filled posts comprising substantive consultant psychiatrists is 84.8% (4,353), similar to the percentage in the 2021 census (84.7%). 15.8% (963) vacant or unfilled consultant posts were reported in 2023, an increase of 6.0 percentage points on 9.8% (713) in 2021, 6.6 percentage points greater than 9.2% (708) in 2019 and 6.7 percentage points greater than 9.1% (537) in 2017.
12.8% (780) of all consultant posts were filled by locum psychiatrists, a reduction of 1.0 percentage point from 13.8% (1,005) in 2021, however, an increase of 0.9 percentage points from 2019 (11.9%, 915 posts). The current true vacancy rate, including both locum and vacant consultant posts, is 28.6%.
Although the mental health workforce has expanded since 2017, according to the King’s Fund analysis, this is not enough to meet current demand and any planned expansion of services. The sector has high vacancy rates and the push for recruitment has resulted in many more newly qualified staff and a change in skill mix of staff, for example less registered nursing staff and more support staff, which is having a direct impact on staff morale and patient care.
An analysis of CQC inspection reports shows that staffing problems are a factor in all those services rated as ‘requiring improvement’ or ‘inadequate’. This impacts on patient safety, and wider patient wellbeing.
Overall, in December 2024, there were 24,519 vacancies in mental health services, including 1,521 medical and 8,395 nursing vacancies.
Vacancies vary by service and setting. The challenges posed by some settings such as inpatient care can also create difficulties in recruiting staff to these posts, and in some cases there is an increasing reliance on bank or agency staff.
Lack of staff causing health issues for staff
The King's Fund reported in February 2024 that the latest NHS Staff Survey (2022) shows that, overall, staff in providers of mental health care report more positive experiences of the workplace than the NHS average. However, there was a decline in several markers of staff satisfaction. Some of this fall in satisfaction is due to staff shortages. An analysis of CQC inspection reports found that in inpatient services, staff regularly work extra hours or additional shifts. Some staff felt they were put in a position where they had to help other wards, but this meant they were working in environments (and with patients) they were unfamiliar with. In community services staff reported feeling worn out and finding work frustrating and stressful as a result of low staffing levels.
Shortage of radiologists
Shortage leads to treatment delays
A UK wide shortage of radiologists is a continuing issue, contributing to treatment delays for patients in cancer care and other medical care.
Data submitted by the Royal College of Radiologists to the Health and Social Care parliamentary committee in 2022, showed that the RCR estimate there is a shortage of 1,939 whole-time equivalent consultant radiologists for the UK – this equates to a 33% shortage. For consultant oncologists, this figure stands at 189 WTE consultants (a 17% shortfall). If current trends in demand and workforce entries and exits continued to 2030, there would be shortages of close to 6,000 consultant radiologists and 700 consultant oncologists.
New community diagnostic hubs take key staff
The government has an ambitious plan to set up over 100 community diagnostic hubs, however these centres will need an extra 3,500 radiographers to carry out diagnostics tests and 2,000 radiologists to interpret the results, as well as 500 advanced practitioners. The drive to recruit the staff needed at the community diagnostic hubs (CDHs) in England risks already-understaffed hospitals losing key staff to work there.
Shortage has been known for some time
Reports in 2020 revealed that the consultant radiologist workforce in England is 35% short-staffed. Scotland (31%), Wales (37%) and Northern Ireland (27%) have similarly high shortages. In order to keep up with demand and safe staffing quotas, NHS England needs at least an extra 1,613 full-time equivalent consultants.
The Royal College of Radiologists have reported that NHS hospitals are increasingly having to pay for staff to do overtime or outsource the analysis of complex scans to private companies to cover the shortfall.
The work of radiologists is a central component to a lot what the NHS does and so these staff shortages can have a substantial impact on the NHS by prolonging waiting times.
Too few anaesthetists being trained
In February 2022 the Royal College of Anaesthetists published the report - The Anaesthetic Workforce: UK State of the Nation Report - that warned that more than eight million operations per year will be cancelled or delayed by 2040 unless anaesthetic workforce shortages are addressed.
The report noted that already there is a shortage of 1,400 anaesthetists, which means that 1 million operations can not be carried out. The shortage will only get worse, with 8.25 cancelled operations each year by 2040 and a shortage of 11,000 anaesthetic staff. The situation is due to a combination of a weary workforce, burnout and staff sickness, plus a lack of training places to train staff to replace those due to retire.
The report shows that without investment in training posts for anaesthetists the situation will only worsen. The report pressurised Health Education England to fund more training places, unfortunately this was only an increase in 100, 70 anaesthetists and 30 intensivists.